Polycystic ovarian syndrome (PCOS)
Around the world approximately 11% of women suffer from PCOS or polycystic ovarian syndrome. It also accounts for approximately 40% of female infertility, making it one of the leading causes of people struggling to get pregnant naturally.
It’s a complex condition that can be related to elevated cholesterol, an insulin imbalance and a tendency towards unwanted weight gain. It’s the most common hormonal disorder for women in the reproductive stage of their life - the time from when a woman’s periods begin to when they stop at menopause.
The name - polycystic ovary syndrome - is a bit of a red herring. It makes you think the problem is all about your ovaries and that everyone with PCOS has multiple cysts on their ovaries. But the truth is that the cause of PCOS is hormonal, it’s not a problem that affects just the ovaries.
What the Docs think is that increased levels of insulin in the bodies of people with PCOS cause their ovaries to work a bit differently to everyone else. That in turn leads to the production of excessive levels of male-type hormones (androgens) which cause many of the symptoms of PCOS.
At Genea we have quite a few doctors who specialise in treating PCOS and the fertility issues the condition often causes.
Symptoms of PCOS
People with PCOS might suffer from all of these symptoms or only some of them:
- Abnormal or irregular menstrual cycles with very light OR very heavy bleeding
- Excess weight with a high body mass index - many women with PCOS report gaining weight more easily
- A feeling of bloating and heaviness in the lower abdomen
- Areas of darker skin pigmentation
- Abnormal amounts of facial and body hair related to higher levels of androgens
PCOS and fertility
PCOS is the cause lurking behind approximately 40% of female infertility, making it one of the leading causes of people struggling to get pregnant naturally. It’s a complex metabolic disorder but two issues are common:
All women have low levels of male hormones but those with PCOS often have excessive levels in their blood. This is what causes increased facial and body hair, and it can also be associated with a lack of ovulation - stopping eggs from being released to meet with the sperm and form an embryo.
Insulin is needed to regulate blood sugar levels. With PCOS, however, the body becomes resistant to the effects of insulin. This leads to higher insulin levels in the blood, which can also affect ovulation and therefore the ability to get pregnant.
The oral contraceptive pill can correct the hormonal imbalance of PCOS, but if the pill was prescribed to manage irregular cycles and PCOS, poor ovulation and irregular periods usually come back when the pill is ceased. In other words, the pill doesn’t "cure" PCOS.
Many women with PCOS conceive naturally, successfully managing the syndrome by making changes to diet and exercise routines. In some cases, medical intervention is needed and a range of fertility treatments can help with conception.
If you know or suspect that you have PCOS, consulting a doctor for review before trying to conceive is highly recommended.
Treatments for PCOS
The best way to resume ovulation is to have a body mass index in the healthy range (18.5-24.9), so weight loss should be the first priority for women who are overweight. However, we know that can be really difficult for women with PCOS so it’s a great idea to talk with your doctor about different ways to achieve this goal.
For those that have a healthy weight range but are not ovulating, fertility drugs such as clomiphene, letrozole and gonadotrophins may help ovulation.
There is also a surgical treatment called laparoscopic ovarian drilling, this will require a general anaesthetic.
For those struggling to conceive, there are a range of fertility treatments that can support conception if required.